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"[ABSTRAKLatar belakang dan tujuan: Keloid merupakan pertumbuhan berlebih dari kolagen dermis yang dapat menimbulkan masalah fisis dan psikis bagi penderitanya. Berbagai pilihan terapi telah digunakan untuk pengobatan keloid. Penelitian ini membandingkan efikasi dan efek samping antara kombinasi triamsinolon asetonid (TA) dan 5-fluorouracil (5-FU) dengan TA intralesi pada terapi keloid.Metode: Studi eksperimen dengan desain single blind randomized controlled trial (RCT) terhadap pasien keloid. Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat kombinasi 5-fluorourasil dan triamsinolon asetonid intralesi, dan kelompok kontrol yang mendapat terapi tunggal triamsinolon asetonid intralesi. Kedua kelompok diberi pengobatan 1 kali perminggu selama 8 minggu dan lesi keloid diukur tinggi dan volume.Hasil: Penurunan tinggi dan volume terjadi pada kedua kelompok. Pada penurunan tinggi, respons baik terjadi pada 75% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,403). Sedangkan pada penurunan volume, respons baik terjadi pada 58,3% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,713). Sebanyak 5 dari 24 SP pada kelompok intervensi mengalami efek samping berupa gatal, nyeri ringan, ulkus dangkal, dan telangiektasi. Sedangkan pada kelompok kontrol terdapat 7 dari 22 SP yang mengeluh gatal, nyeri ringan, dan telangiektasi.Kesimpulan: Secara umum, efikasi dan efek samping kombinasi TA dan 5-FU intralesi sebanding dengan TA saja.

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ABSTRACTBackground and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone, Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone]"

"ABSTRAKKeloid adalah kondisi abnormal dalam proses penyembuhan luka yang tumbuh menyebar melebihi batas luka normal. Keloid berada dalam kondisi hipoksia relatif yang melibatkan proses adaptasi berupa perubahan lingkungan mikro dari normoksia menjadi hipoksia, termasuk dalam hal ini adalah metabolisme laktat. Monocarboxylate transporters MCTs yang berperan dalam metabolisme laktat pada patogenesis keloid belum jelas dipahami. Oleh karena itu, penelitian ini bertujuan untuk menganalisis metabolisme laktat pada jaringan keloid dengan mengukur ekspresi MCT1 dan MCT4 yang berperan penting dalam transpor laktat melalui membran plasma. Jenis penelitian ini adalah studi observasional deskriptif analitik dengan desain studi potong lintang cross sectional study . Sampel jaringan dan stroma keloid diperoleh dari 3 jaringan keloid dengan metode eksplan dan dibandingkan dengan stroma dari kultur primer dermis preputium sebagai kontrol. Ekspresi mRNA MCT1 dan MCT4 diukur dengan menggunakan quantitative real time-polymerase chain reaction qRT-PCR . Ekspresi protein MCT1 dan MCT4 dideteksi dengan teknik enzyme linked immunosorbent assay ELISA . Kadar laktat ekstraseluler diukur dengan EnzyChromTM L-Lactate Assay Kit. Ekspresi mRNA MCT1 dan MCT4 jaringan dan stroma keloid lebih tinggi bermakna dibandingkan stroma preputium.

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ABSTRACTKeloid is an abnormality of wound healing process that growing spread beyond the limits of normal injury. Keloid is in relative hypoxia condition that involves the adaptation of microenvironmental change from normoxia into hypoxia including lactate metabolism. The role of monocarboxylate transporters MCTs in lactate metabolism of keloid patogenensis still not clearly understood. Therefore, the aim of this study is to analyze lactate metabolism in keloid tissue by measuring the expression of MCT1 and MCT4 as the key player of lactate transport through the plasma membrane as in tumor microenvironment. The type of this research is descriptive analytic observational study with cross sectional study design. Keloid samples derived from 3 keloid tissue culture using explants method and compared with primary cultures of dermis foreskin as a control. MCT1 and MCT4 mRNA expression were measured using real time quantitative polymerase chain reaction qRT PCR. MCT1 and MCT4 protein expression was detected by using enzyme linked immunosorbent assay ELISA . Extracellular lactate levels measured by EnzyChromTM L Lactate Assay Kit. MCT1 and MCT4 mRNA expression of keloid tissues and stromal cells significantly higher compared with foreskin fibroblasts p"

"ABSTRAKPendahuluan: Keloid adalah tumor jinak pada kulit yang ditandai denganpeningkatan deposisi kolagen yang disebabkan oleh tingginya aktivitas danproliferasi fibroblas. Karakteristik utama dari keloid adalah berada pada kondisihipoksia. Hypoxia inducible factor-1alpha HIF-1? dan HIF-2? merupakansubunit faktor transkripsi HIF-1 dan HIF-2 yang berperan penting pada adaptasiterhadap kondisi hipoksia. Kondisi hipoksia juga memicu sel memproduksireactive oxygen species ROS yang dapat ditangkal oleh sitoglobin Cygb . Padakeloid, Cygb juga berperan pada sintesis kolagen. Penelitian lain membuktikanbahwa terdapat situs pengikatan promoter HIF-1 pada hypoxia response element HRE Cygb, sedangkan situs pengikatan HIF-2 pada Cygb belum diketahui. HIF-1? dan HIF-2? juga diketahui berperan menginduksi ekspresi gen yang berperanpada proliferasi. Keduanya diketahui mengatur proliferasi sel pada beberapa jeniskanker. Namun, peran HIF-1? dan HIF-2? terhadap ekspresi Cygb dan proliferasifibroblas pada keloid belum diketahui. Oleh karena itu, penelitian ini bertujuanmengetahui peran HIF-1? dan HIF-2? terhadap ekspresi sitoglobin dan proliferasifibroblas pada keloid, dengan melakukan penghambatan HIF-1? dan HIF-2? padafibroblas keloid menggunakan inhibitor HIF berupa ibuprofen. Metode:Pemeriksaan dilakukan terhadap ekspresi mRNA dan kadar protein HIF-1?, HIF-2?, dan sitoglobin, menggunakan metode qRT-PCR dan ELISA, serta proliferasisel menggunakan metode trypan blue exclussion assay setelah diberi ibuprofendan dibandingkan dengan kontrol yang tidak diinduksi dengan ibuprofen. Hasil:Penghambatan HIF-1? menyebabkan terjadinya penurunan ekspresi mRNA Cygbdan proliferasi fibroblas pada keloid. Hal ini membuktikan bahwa HIF-1?berperan sebagai faktor transkripsi Cygb, dan juga berperan menginduksi ekspresigen yang berperan pada proliferasi fibroblas keloid. Akan tetapi, peran HIF-2?dalam meregulasi sitoglobin dan mempertahankan proliferasi fibroblas keloidbelum berhasil dibuktikan. Kesimpulan: HIF-1? berperan meregulasi eksrepsiCygb dan berperan pada proliferasi fibroblas keloid. Akan tetapi, HIF-2? belumterbukti meregulasi eksrepsi Cygb dan berperan pada proliferasi fibroblas keloid.

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ABSTRACTBackground Keloid is a benign tumor which is characterized by overabbundance of collagen deposition caused by high activity and proliferation offibroblast. The main characteristics of keloid is hypoxia. HIF 1 and HIF 2 aretwo subunits of transcrption factors HIF 1 and HIF 2 which mediate adaptationto hypoxic condition. Hypoxic condition also induces cells to produce reactiveoxygen species ROS which can be scavenged by cytoglobin Cygb . In keloid,Cygb also plays important role in collagen synthesis. Other studies prove thatthere is a binding site of HIF 1 promoter on hypoxia response element HRE ofCygb. Whereas, HIF 2 binding site on HRE of Cygb is not cleraly understood.HIF 1 and HIF 2 also play important role to induce expression of many geneswhich involved in cells proliferation. Both HIF 1 and HIF 2 are known toregulate cells proliferation in many cancer types. However, the role of HIF 1 andHIF 2 to Cygb expression and fibroblast proliferation in keloid is not fullyunderstood. Therefore, the aim of this study is to determine the role of HIF 1 andHIF 2 on Cygb expression and fibroblast proliferation in keloid, by doing aninhibition of HIF 1 and HIF 2 in keloid fibroblast primary culture usingibuprofen as HIF inhibitor. Methods Analysis was conducted by analizing HIF 1 , HIF 2 , and Cygb mRNA expression and protein level using qRT PCR andELISA, and fibroblast proliferation analysis was conducted using trypan blueexclusion assay after given with ibuprofen and compared with control which isnot given with ibuprofen. Results Inhibition of HIF 1 caused a decrease onCygb mRNA expression and fibroblast proliferation on keloid. These findingsprove that HIF 1 acts as transcription factor of Cygb, and also inducesexpression of gene which plays a role on fibroblast proliferation in keloid.However, the role of HIF 2 in regulating and maintaining Cygb expression andfibroblast proliferation in keloid was not succesfully proven. Conclusion HIF 1 regulate Cygb expression and fibroblast proliferation in keloid. However, HIF 2 role on Cygb expression and fibroblast proliferation has not be proven yet."